Extracted text (via ocr_local)
7555 characters
Arizona Department of Liquor Licenses and Control DLLC USE ONLY
https://www.azliquor.gov Job #:
(602) 542-5141 Date Accepted:
Lc;
SPECIAL EVENT LICENSE
APPLICATION FEE $25.00 PER DAY Heense:
MUST be submitted to the Department of Liquor 10 days prior to the event.
SECTION 1
Name of Non-Profit Organization, Candidate or Political Party: + ‘le aling UY tl v Lene
If the event will be held on an unlicensed premises, it IVIUST be approved and signed by the Local Governing
Body Before submitting to the Arizona Department of Liquor.
LOCAL GOVERNING BODY
Date Received:
Oa~pprovat C1 pisapprovat
Government Official Title
On behalf of
City, Town, County Signature
SECTION 2
Will the event be at a location with a current liquor license and within the approved and licensed area?
Lyes MINo (if no skip to section 3)
If yes, MUST attach a letter of explanation/permission/suspension from the licensed location and choose ONE option below.
Name of Licensed Location. Liquor License Number
[1 Suspend license for the duration of the Special Event; Licensee selling all alcoho! without retailer involvement.
Letter of suspension required.
[1 _ Dispense and serve all spirituous liquors under retailer’s license — Business operates normally, minimum of 25% of
gross revenue from alcohol sales will be donated to licensee. Letter of permission required.
[1 Dispense and serve all spirituous liquors under special event - The special event licensee is in charge of selling alcohol
that was purchased or donated by the special event licensee. The retailers existing alcohol inventory must be kept
separate from any alcohol used during the special event. Letter of suspension required.
CI Split premises between special event and licensed location - Both the special event licensee and the licensed
location will conduct sales of alcohol. (These sales must be done in separate areas. If alcohol is donated or purchased
by the special event licensee, it must be in a separate area from the alcohol that is dispensed by the licensed
location.) Letter of explanation and permission required.
| Off Sale only - Wine/Distilled Spirits Pull, Live or Silent Auctions — Retailer will be permitted to conduct all normal
sales and service of alcohol. Letter of permission required.
10/28/2025 Page lof 4
Individuals requiring ADA accommodations please call (602)542-2999
SECTION 3
Applicant MUST be a member of a qualifying nonprofit organization, political party, or Government entity and
authorized by an Officer, Director, or Chairperson of the Organization.
1. Applicant: Atkinson Katia
Last iddle
2. Applicant’s mailing =
3. Applicants home/cell phone’ Non-profit organization phone: 480-974-8874
dgpiieieanlher =:
5. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?
Lives (if yes, attach letter of explanation) WM No
SECTION 4
1. Name of non-profit organization: Healing with Love
2. Non-Profit/IRS Tax Exempt Number: 99-4482069 Arizona Corporation Commission File #: 23712924
Required Required
3. If Out Of State, specify State (Attach letter of good standing):
4. Special Event Name: Party in The Desert
SECTION 5
5. Event Location Name: Flying E Ranch
2801 W Wickenburg Way Wickenburg AZ 85390
6. Event Address:
SECTION 6
Must list type of security and control measures will you take to prevent violations of liquor laws at this event.
10 Number of Police 2 Number of Security Personnel Mrencing Mearriers
Must explain security measures: Over 21 ID check with risk bands-train bartenders and coordinated with loc
Jocer| informent
and
1, How is this special event going to conduct all dispensing, serving, and selling of spirituous liquors?
Check one of the following boxes. (R-19-318)
Mlon-site consumption Llottsite (auction/wine/distilled spirits pull) Lsoth
2. How many special event days have already been issued to this organization during the current year? 0
10/28/2025 Page 2 of 4
Individuals requiring ADA accommodations please call (602)542-2999
SECTION 7
Dates and Hours of Event - Days must be consecutive and may not exceed 10 days per year.
DAYS DATE DAY OF WEEK aver aTeAUin
DAY 4 3/20/26 Friday 5pm 12am
DAY2 3/21/26 Saturday 11am 6pm
DAY 3 3/22/26 Sunday 11 am 6pm
DAY A 3/23/26 Monday 11 am 6pm
DAYS 3/24/26 Tuesday 11 am 6 pm
DAY 6 3/25/26 Wednesday 11am 6 pm
DAY7 3/26/26 Thursday 4pm 2am
DAY 8 3/27/26 Friday 4pm 2am
DAY9 3/28/26 Saturday 12pm 2am
DAY 10 3/29/26 Sunday 11 am 10 pm
SECTION 8
1. Is the Organization using the services of a DLLC approved Special Event Contractor from the list on our website?
[Wes [VINo If yes, please provide the Name of the Special Event Contractor:
Special Event Contractor Signature:
2. Is the organization using the services of a series 6, 7, 11, or 12 licensee to manage the sale or service of alcohol?
(Licensees who hold a series 6, 7, 11, or 12 license are automatically qualified to be a special event contractor)
[Wes [YINo if yes, Name of Licensee: Liquor License #:
3.List the name of the Organization/individual that will receive revenues:
MUST EQUAL 100 PERCENT, APPLYING NON-PROFIT MUST RECEIVE A MINIMUM OF 25% OF THE PROCEEDS.
Name: Flying E Ranch Holding LLC Percentage: 75%
waarese: 2801 W Wickenburg Way Wickenburg AZ 85390
Street City State Zip
Name: Healing with Love Percentage: 25 %
Address: 2620 E Greenway Pkwy Suite 202 Phoenix 85032
Street City State Zip
Please read A.R.S. § 4-203.02 and R19-1-205 Special event license rules and Requirements.
10/28/2025 Page 3 of 4
Individuals requiring ADA accommodations please call (602)542-2999
SECTION 9
Licensed location diagram: The licensed premises for your special event is the area in which you are
authorized to sell, dispense, or serve alcoholic beverages under the provisions of your license.
=> ATTACHDIAGRAM @&
Must attach a diagram of your special event showing the area where alcohol will be sold, |
served, and consumed. Must include dimensions of event area, fencing, barricades,
or other control measures, and include positions of security personnel.
NO ALCOHOLIC BEVERAGES SHALL LEAVE A SPECIAL EVENT UNLESS THEY ARE IN SEALED CONTAINERS FOR AN AUCTION OR
WINE/DISTILLED SPIRITS PULL, OR THE SPECIAL EVENT LICENSE IS STACKED WITH A WINE /CRAFT DISTILLERY FESTIVAL LICENSE.
Declaration: ;
|, (Print Name) Katia Atkinson , declare under penalty of perjury that | am
authorized to submit this application. | have read the contents and to the best of my knowledge believe all statements
made on this application to be true, correct, andcomplete. 42
Signature:
SPECIAL EVENT DIAGRAM AND
SAFETY PLAN STANDARDS
Diagrams do not need to be overly complicated, they can be hand drawn. However, we
do not accept photographs or aerial views that do not show the premises clearly. The
diagram should clearly depict the special event area in relation to the entire premises.
Each diagram must include:
e Overview of the location
e The event area clearly outlined with black marker
e Where alcohol will be served/stored
e All entrances and exits
e Where security will be positioned
e Square footage of event area
e Show North, East, South, West
10/28/2025 page 4 of 4
Individuals requiring ADA accommodations please call (602)542-2999
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